| NPI | 1114056884 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD451393) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35.096843) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2022-04-07 |